Comparison of outcomes following resection of right-sided and left-sided colon cancer

Abstract

INTRODUCTION: It is unclear whether the location of colon cancer determines the prognosis of the patients. ln this study, the characteristics and survival of patients with right-sided and left-sided colon cancers were compared. MATERIAL AND METHODS: This is a retrospective review from a prospectively collected database comparing the characteristics and survival of patients with right-sided and left-sided cancer. Lesions proximal to the splenic flexure were considered as right-sided cancer and those at or distal to the splenic flexure were considered left-sided cancer. Patients with rectal cancers and those without bowel resections were excluded. Patients with synchronous cancers involving both sides were also excluded. The operative details, postoperative outcomes, pathology characteristics and follow up status were collected prospectively. RESULTS: From 1996 to 2007, after excluding 20 patients with synchronous cancers involving sides of the colon, 1647 patients (893 men) with the median age of 72 (range: 22-96) years old underwent resection for colon cancer. Four hundred and thirty patients (26.1%) were operated as emergency. The 30-day mortality was 3.8% and the postoperative morbidity was 24.8%. The patients with right-sided cancer were older (mean age 71.2 vs. 68.4 years old, p=0.033) and more of them had comorbid medical conditions (59.2% vs. 53.6%, p=0.029). There was no difference in the gender, urgency of operation, stage of the diseases, operative mortality and morbidity between the two groups. However, the survival of patients with right-sided cancer is significantly worse that that of patients with left-sided cancer (47.6% vs. 52.3%, p=0.01). CONCLUSIONS: From the study, the survival of patients with right-sided colon cancer is worse than that of patients with left-sided cancer. Fur ther investigations to define the causes for the difference is warranted